On one hand, Deborah Radcliffe-Branch is lucky. She does not suffer from the relentless chronic pain affecting so many participants in the program she heads at the McGill University Health Centre.

Still, the director of the “My Tool Box” Chronic Disease Self-Management Program is on intimate terms with pain. The migraines, which started when she was 12, were so debilitating that some days she missed school. They were at their worst when she was in her 20s, so crippling that some days she couldn’t work.

She tried everything, from medication and biofeedback to mindfulness courses, but nothing helped enough. She was a single mother, working hard in the insurance business and going to school at night. “There was a lot of pressure on me,” recalled Radcliffe-Branch, now 54. “I remember it being hugely, overwhelmingly, difficult.

“The pain takes over your entire persona — your body and your mind. It is so difficult to function. … It was a very dark period: I still had to take my daughter to school and cook and clean and work and do everything else.

“And especially at that time, employers were not impressed if you couldn’t come in. They thought a migraine was just a headache — we’re more aware now — but some days were impossibly difficult. There was one job I’m pretty sure I lost due to absenteeism.”

In her early 30s, Radcliffe-Branch went back to school. Today, she has a PhD in educational psychology. She still gets migraines, accompanied by nausea and vomiting, but they’re less disabling than they once were and rarely last more than a day. Work is still a challenge: “You do not want to face a computer screen when you have a migraine,” she said. “I try to do other work — but, sometimes, you have to get through it.

“It’s a real curse. But seeing our patient population and what they are living with makes me feel fortunate that all I live with is a migraine.”

Radcliffe-Branch began the My Tool Box program as a pilot project at the McGill University Health Centre in 2006. So far, it has seen 1,900 participants in 150 groups. Patients include people with chronic health conditions including cancer, heart disease, arthritis and multiple sclerosis. Related problems often include depression, sleep problems and difficulty communicating with health-care providers.

Imagine not being able to turn the ‘off’ switch. Other people don’t understand. They think, ‘You look fine. Stop complaining and get on with life.’ — Deborah Radcliffe-Branch

There is a separate group for people suffering with chronic pain — “a very different thing, obviously, because the individual is in pain 24/7,” Radcliffe-Branch said in an interview during National Pain Awareness Week earlier this month.

“Imagine not being able to turn the ‘off’ switch. Other people don’t understand. They think, ‘You look fine. Stop complaining and get on with life.’ People often feel alienated from family and friends. And there are so few resources for them.”

In the My Tool Box program, which features six weekly 2½-hour sessions, participants “learn problem-solving skills that will help them in day-to-day management of their problems” — and learn from each other, explained Radcliffe-Branch, who was doing post-doctoral work at the Université de Montréal when a supervisor told her about it.

She says she wishes the course had been available when she was younger.

Deborah Radcliffe-Branch works in her office at the MUHC, administrative building in Montreal, Wednesday, November 5, 2014. She is director of a workshop program intended to help people to cope with chronic conditions, including chronic pain.Phil Carpenter /
Montreal Gazette

“This is not somewhere you come to chat,” she said, noting it is not a support group. “It’s structured, with subjects to cover. … Participants learn strategies and share knowledge.” The program, which originated at Stanford University, has been translated into 18 languages. Training is standardized and delivered by volunteer peer leaders “who know what the others are going through” because they, too, have chronic health conditions.

There is evidence that the research-based program, now in place across Canada, is effective: Overnight hospital stays and emergency-room visits are reduced by one-third to one-half among people who have been through the program, said Radcliffe-Branch, an assistant professor in the faculty of medicine at McGill. Pain levels and depression, anxiety and fear are also reduced.

A participant in one of the Montreal groups who has Parkinson’s disease wrote in a testimonial: “My Tool Box was, for me, a coming out of sorts. It allowed me to voice my health condition publicly for the first time. I felt supported and less burdened. The information sessions and discussions left me feeling optimistic about my future and my ability to take control … the personal accounts of the co-facilitators and other participants were invaluable.”

The My Tool Box program is offered, free of charge, in English and in French, at McGill and elsewhere. There are 10 to 12 participants per group. Go to mytoolbox.mcgill.ca to learn more. To register, contact Dawn Upfold at 514-934-1934, ext. 71585.

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